title: Clinical utility of the Colorado Learning Difficulties Questionnaire.
abstract: OBJECTIVE
  Behavioral disorders are highly comorbid with childhood learning disabilities (LDs), and accurate identification of LDs is vital for guiding appropriate interventions. However, it is difficult to conduct comprehensive assessment of academic skills within the context of primary care visits, lending utility to screening of academic skills via informant reports. The current study evaluated the clinical utility of a parent-reported screening measure in identifying children with learning difficulties.
  
  
  METHODS
  Participants included 440 children (66.7% male), ages 5.25 to 17.83 years (mean = 10.32 years, SD = 3.06 years), referred for neuropsychological assessment. Academic difficulties were screened by parent report using the Colorado Learning Difficulties Questionnaire (CLDQ). Reading and math skills were assessed via individually administered academic achievement measures. Sensitivity, specificity, classification accuracy, and conditional probabilities were calculated to evaluate the efficacy of the CLDQ in predicting academic impairment.
  
  
  RESULTS
  Correlations between the CLDQ reading scale and reading achievement measures ranged from -0.35 to -0.65 and from -0.24 to -0.46 between the CLDQ math scale and math achievement measures (all P < .01). Sensitivity was good for both reading and math scales, whereas specificity was low. Taking into account the high base rate of reading and math LDs within our sample, the conditional probability of true negatives (96.2% reading, 85.1% math) was higher than for true positives (40.5% reading, 37.9% math).
  
  
  CONCLUSIONS
  Overall, the CLDQ may more accurately predict children without LDs than children with LDs. As such, the absence of parent-reported difficulties may be adequate to rule out an overt LD, whereas elevated scores likely indicate the need for more comprehensive assessment.
authors.affiliation: Department of Neuropsychology, Kennedy Krieger Institute, 1750 East Fairmount Ave, Baltimore, MD 21231. jacobson@kennedykrieger.org.
authors.forename: Kristina E
authors.initials: KE
authors.lastname: Patrick
authors.forename: Mark D
authors.initials: MD
authors.lastname: McCurdy
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Chute
authors.forename: E Mark
authors.initials: EM
authors.lastname: Mahone
authors.forename: T Andrew
authors.initials: TA
authors.lastname: Zabel
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Jacobson
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003120:Colorado; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards*; D010287:Parent-Child Relations; D012372:ROC Curve; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: ADHD; achievement testing; learning disorders; rating scales; sensitivity; specificity